The state of knowledge of young italian medicolegal doctors on the law of provisions for informed consent and advance treatment directives: A multi-centric survey two years after the enactment of law 219 of 2017

Background. On 22 December 2017, Law No. 219 was approved in Italy entitled “Provisions on informed consent and advance treatment directives”. This article reports the results from a survey of the knowledge of medico-legal experts in Italy on these provisions, in addition to the ability of university health-care facilities in Italy to implement the principles of this new law. Methods. A survey questionnaire was sent to members of a scientific society. The society had 357 members and represented more than 75% of doctors in training and 32 university healthcare facilities in Italy. 27 of those facilities and 45% of the society’s members participated in this enquiry. Results. The majority (68%) of those interviewed felt they had acquired an adequate knowledge of the law but only 60% of them were able to indicate how to file legally valid advance directives (60% vs. 40%); only 37% knew how to draft a shared care plan. 89% of the pool felt that legal recognition of patient self-determination enhanced the care relationship. 74% of the facilities analyzed have organized training activities on the contents of the law but only 26% have updated their informed consent forms and procedures. 60% of the facilities perform medico-legal consultation activities and in 15% of the facilities there has been resistance to applying the law. Conclusion. Many of the facilities have set up training activities but lack effective implementation of those activities. With increased knowledge and organization this could be remedied. (www.actabiomedica.it)